Art of Psychiatry Society

By Nicole Leistikow

Discussion of Rachel Cooper’s Psychiatry and Philosophy of Science made for a cozy chat on a wintry December 5th evening, accompanied by pasta and pinot noir. Cooper’s straightforward prose and promptly terminated sentences came as a relief after the group had grappled with Thomas Szasz a few months before. It didn’t hurt that she takes on Szasz with refreshing clarity: “Szasz claims that mental illness is a myth, but he is wrong about this.” She goes on to explain that when the best explanation for a behavior is “sub-personal,” meaning biological and physiological in origin, then that behavior can be thought of as a symptom of a mental illness rather than a purposeful action. She was rather preaching to the choir in this setting, as all around the table, from attending to intern, had spent recent time on the inpatient wards and had difficulty viewing acute exacerbations of psychosis as anything intentional.

On the topic of psychosis, the discussion leader tried to interest the group in the question of whether psychiatrists should take LSD to better understand this phenomenon from the inside, an actual 1956 experiment that Cooper describes, but the chocolate truffles must have been too satisfying, because no one would make the argument that further chemical stimulation was needed. This did spur conversation on the role of empathy in treatment, and whether doctors who are simple prescribers need any warmth at all to do their job. The point was made that whether writing scripts for anti-psychotics or anti-hypertensives, physician’s acting with empathy can impact patient buy-in and adherence.

From there, the question turned to dualism and reductionism, and whether practitioners of the latter are less empathic, as people. Cooper seems to be trying to make peace between the various factions, concluding that “dualism is compatible with all neuroscientific findings” and that most reductionists can still agree that mental states are something more than brain states. The Churchlands’ views on eliminative materialism were discussed and a 2007 New Yorker was produced along with a delightful imagined conversation of Paul and Patricia Churchland after a long day of work attributing their mental states purely to neurotransmitter flux. The evening ended early with the call of toddlers for some and “tea” for others, as the group sallied forth into the snowy chill to take up their various domestic and social responsibilities, encouraged by the conclusion that if psychiatry is not purely a science, it is a practical discipline with enough rigor to be analyzed and made clearer by the likes of Rachel Cooper.